tbuckley/cabot-search huggingface dataset:
Trends in palliative care interventions for stage IV esophageal cancer: An analysis of the NCDB.
Authors: Michael Seraphin, Peter T. Silberstein, Gregory Cichon
Journal: Journal of Clinical Oncology (2022)

e24104 Background: Palliative care (PC) addresses patient quality of life and satisfaction with care. Oncological PC can be manifested through surgery, radiation, chemotherapy, and pain management. These treatments do not cure disease but improve quality of life. The survival rate for stage IV esophageal cancer is 15-20%, making it an excellent candidate for PC. This study will analyze patterns in who received each type of PC. Methods: This study looked at 8808 patients with stage IV esophageal cancer who received PC interventions from 2004-2018 in the National Cancer Database (NCDB). The NCDB listed 4 types of PC: surgical, radiation, chemotherapy/hormone therapy, and pain management. All modalities were to “alleviate symptoms, but no attempt to diagnose, stage, or treat the primary tumor is made.” Exclusion criteria was concurrent tumors and missing data. Histology subgroups were divided into adenocarcinoma, squamous cell carcinoma, and other, based on ICD-O-3 coding. Cross tabulation analysis was performed using Pearson chi-square and ANOVA tests. Kaplan Meyer curves with log-rank analysis were used to determine survival probabilities. Results: Of PC interventions, 9.0% were surgical, 42.5% radiation, 41.1% chemotherapy, and 7.4% pain management with no other treatment. From 2004-2018 pain management increased 380% and chemotherapy increased 250%. Radiation increased 32%, and surgical decreased 39%. Surgical patients were more often male (79.9%), white (87.4%), non-Hispanic (97.3%), treated at an academic/research program (39.6%), and have a mean survival of 8.6 months. The most common surgical interventions were photodynamic therapy and esophagectomy with partial gastrectomy. Radiation patients more often male (82.3%), white (83.9%), non-Hispanic (96.5%), treated at a comprehensive community cancer center (39.7%), and have a mean survival of 9.1 months. Most common phase I radiation treatments were external beams (photons) and external beams NOS. Chemotherapy patients were more likely to be male (84.5%), white (88.2%), non-Hispanic (96.8%), treated at a comprehensive community cancer program (39.4%), and have a mean survival of 13.9 months. Chemotherapy patients most often received multiagent chemotherapy and single agent chemotherapy. Pain management patients were more often male (80.2%), white (88.0%), non-Hispanic (96.5%), treated at an academic/research program (38.8%), and have a mean survival of 4.1 months. Chemotherapy patients had average age of 62, while all other interventions had an average age of 65 (p &lt; 0.001). Conclusions: Major differences between subtypes of PC interventions included location of treatment, average age at diagnosis, and mean survival. Chemotherapy patients were diagnosed younger and had a longer mean survival time. Pain management patients had the lowest mean survival time. This data can be utilized as PC utilization increases in the United States.
Outcomes following treatment for ADA-deficient severe combined immunodeficiency: a report from the PIDTC
Authors: Geoffrey D. E. Cuvelier, Brent R. Logan, Susan E. Prockop, Rebecca H. Buckley, Caroline Y. Kuo, Linda M. Griffith, Xuerong Liu, Alison Yip, Michael S. Hershfield, Paul G. Ayoub, Theodore B. Moore, Morna J. Dorsey, Richard J. O’Reilly, Neena Kapoor, Sung-Yun Pai, Malika Kapadia, Christen L. Ebens, Lisa R. Forbes Satter, Lauri M. Burroughs, Aleksandra Petrovic, Deepak Chellapandian, Jennifer Heimall, David C. Shyr, Ahmad Rayes, Jeffrey J. Bednarski, Sharat Chandra, Shanmuganathan Chandrakasan, Alfred P. Gillio, Lisa Madden, Troy C. Quigg, Emi H. Caywood, Blachy J. Dávila Saldaña, Kenneth DeSantes, Hesham Eissa, Frederick D. Goldman, Jacob Rozmus, Ami J. Shah, Mark T. Vander Lugt, Monica S. Thakar, Roberta E. Parrott, Caridad Martinez, Jennifer W. Leiding, Troy R. Torgerson, Michael A. Pulsipher, Luigi D. Notarangelo, Morton J. Cowan, Christopher C. Dvorak, Elie Haddad, Jennifer M. Puck, Donald B. Kohn
Journal: Blood (2022)
Local treatment of metastasis in metastatic RCC may have a significant survival effect across all risk of recurrence groups
Authors: L. Serra De Oliveira Marconi, S. Dabestani, B. Ljungberg, A. Volpe, S. Fernandez-Pello, U. Capitanio, T. Lam, G. D Stewart, C. Beisland, T. Klatte, T. Kuusk, A. Bex
Journal: European Urology (2022)
Service evaluation of the utilisation and impact of PredictProstate on clinical decision-making in a prostate cancer specialist multidisciplinary service
Authors: I. Pryle, M. Pandiaraja, L. West, L. Gardener, O. Shallcross, J. Tay, N. Shah, V. Gnanapragasam, B.W. Lamb
Journal: European Urology (2022)
Effect of EGFR amplification on survival of patients with EGFR mutation-positive non-small cell lung cancer.
Authors: Yiquan Xu, Haibo Wang, Xinlong Zheng, Gen Lin
Journal: Journal of Clinical Oncology (2022)

e21000 Background: Epidermal growth factor receptor (EGFR) mutation is a common mutation in non-small cell lung cancer (NSCLC). Patients with EGFR mutation generally respond well to EGFR-tyrosine kinase inhibitors (EGFR-TKIs). EGFR mutation are often co-occurring with EGFR amplification. However, the effect of EGFR amplification on the survival of patients with EGFR mutations remained unclear. Methods: Treatment-naïve adult patients with advanced NSCLC and EGFR mutation confirmed by next generation sequencing (NGS) at Fujian Provincial Hospital between April 2017 and October 2021 were enrolled in this retrospective clinical study. The patients’ clinical characteristics, gene mutations, treatment and clinical outcomes were extracted. progression-free survival (PFS) and overall response rate (ORR) were compared between EGFR amplification and non-EGFR amplification groups using the Kaplan-Meier method and log-rank test. Results: EGFR amplification and non-EGFR amplification were identified in 55 patients (36.67%) and 95 patients (63.33%), and there were no significant differences in clinical characteristics. No significant differences between the EGFR amplification and non-EGFR amplification groups in median PFS (247 vs. 214 days, P = 0.605). The ORR in EGFR amplification group is higher than non-EGFR amplification group (60.87% vs 32.69%). Conclusions: There is a tendency that EGFR amplification might not be a well predictor in EGFR mutation positive NSCLC patients treated with EGFR-TKIs.
The resilience myth
Authors: Peter Brindley, Steve Reynolds
Journal: BMJ (2022)

We just finished a week of clinical service in intensive care units (ICUs) on opposite sides of the Canadian Rockies: one in Edmonton, one in Vancouver.Despite covid's continued presence, we did not have an especially crushing week.Regardless, we often chat as we return to the "real world," and we recommend this "emotional pat-down" to others.A recent check-in confirmed we are both tired…fair enough.What was more concerning was an unfamiliar sense of despondency and listlessness.Perhaps, this is because after two years of a pandemic, even an average week adds to the toll.Perhaps, this is what it feels like being a half-century old, and a quarter-century at work.Perhaps, it's because this is a peculiar job that reliably includes sadness and sleep-deprivation.Perhaps, perhaps, but these gnawing frustrations likely require more than a coffee card and an occasional weekend off.They also appear to be widespread and commonly discussed around the proverbial watercoolers (ironically, the literal watercoolers have been removed because of covid).Regardless, it's not just the staff and it's not just the patients, and it's not just the families: for once, we really are all in this together.
Teleconsultation in respiratory medicine – A position paper of the Portuguese Pulmonology Society
Authors: A. Morais, A. Bugalho, M. Drummond, A.J. Ferreira, A.S. Oliveira, S. Sousa, J.C. Winck, J. Cardoso
Journal: Pulmonology (2022)

The COVID-19 pandemic crisis, among so many social, economic and health problems, also brought new opportunities. The potential of telemedicine to improve health outcomes had already been recognised in the last decades, but the pandemic crisis has accelerated the digital revolution. In 2020, a rapid increase in the use of remote consultations occurred due to the need to reduce attendance and overcrowding in outpatient clinics. However, the benefit of their use extends beyond the pandemic crisis, as an important tool to improve both the efficiency and capacity of future healthcare systems. This article reviews the literature regarding telemedicine and teleconsultation standards and recommendations, collects opinions of Portuguese experts in respiratory medicine and provides guidance in teleconsultation practices for Pulmonologists.
HRAS expression predicts Lenvatinib responsiveness in human primary gastroenteropancreatic neuroendocrine tumor cells.
Authors: Chiara Liverani, Chiara Spadazzi, Alberto Bongiovanni, Federica Pieri, Flavia Foca, Chiara Calabrese, Giorgio Ercolani, Davide Cavaliere, Alessandro De Vita, Giacomo Miserocchi, Claudia Cocchi, Silvia Vanni, Nicoletta Ranallo, Stefano Severi, Maddalena Sansovini, Anna Guariniello, Monica Sbrancia, Giovanni Martinelli, Toni Ibrahim, Laura Mercatali
Journal: Journal of Clinical Oncology (2022)

e16211 Background: Neuroendocrine neoplasms (NENs) are a rare group of heterogeneous tumors, with clinical presentation ranging from indolent and small lesions to very aggressive, metastatic and therapy refractory forms. Despite a high number of trials, few drugs have been introduced in the clinical practice and therapeutic options for systemic intervention are limited. The recent TALENT trial demonstrated the efficacy of Lenvatinib, a multi-tyrosine kinase inhibitor (MKI), in the treatment of patients with advanced well differentiated gastroenteropancreatic neuroendocrine tumors (GEP-NET) progressing from targeted therapies or somatostatin analogues with no other treatment indication. Lenvatinib might represent a novel therapeutic opportunity for these rare tumor patients. However, the treatment approach with MKI lacks clinically validated tissue or blood biomarkers to guide patient selection and improve efficacy. Methods: Here we established 11 human primary cultures from patients with GEP-NEN of different grades and sites of origin and assessed the antitumor activity of Lenvatinib compared with standard treatment agents. All primary cultures were molecularly characterized to identify possible predictors of response. Results: Lenvatinib exerted a significant inhibition of cell growth in primary GEP-NET cells, with median survival inhibitions similar or higher than those of standard treatments. Of the 11 primary cultures analyzed in our case series, 6 were classified as responder with survival inhibition higher than 15%, and 5 as non-responder with survival inhibition lower than 15%. A high expression of HRAS in the tumor tissues compared to the matched healthy tissues significantly correlated with responsiveness of primary cells to Lenvatinib. All 5 non-responder patients showed low expression of HRAS, while of the 6 responder patients, 5 showed a high HRAS expression and only 1 low. None of the other evaluated clinical variables (grade, Ki67, site of origin and syndromic disease) correlated with response. Conclusions: In conclusion, we believe that the evaluation of HRAS expression and mutation might be of great interest in GEP-NET patients receiving Lenvatinib to improve patient selection.
Beyond biomarker testing: Aligning the needs of oncologist and diagnostic companies to improve biomarker results reports for accurate clinical treatment selection.
Authors: Christine M. Lovly, Nikki A. Martin, Upal Kunal Basu Roy
Journal: Journal of Clinical Oncology (2022)

e18611 Background: The benefits of precision medicine, including targeted therapies and immunotherapy, for lung cancer patients are well-documented. National clinical guidelines recommend broad multiplex molecular panels for advanced stage NSCLC. Increased understanding of the molecular heterogeneity of lung cancer has led to novel biomarkers being discovered, increasing the potential to match patients to new treatments. Pairing a patient to the correct biomarker-defined therapy is dependent on both biomarker test being ordered and accurate interpretation of test results. However, the increasing complexity of biomarker reports could contribute to inaccurate diagnoses and suboptimal therapeutic selections. Our objective was to understand the extent of the problem of report interpretation and identify opportunities for harmonizing key elements of the reports, in order to improve report interpretability and patient care. Methods: A multi-stakeholder group comprised of 40 leaders from thoracic medical oncology, professional societies, government agencies, and diagnostic companies was convened by LUNGevity Foundation. Participants responded to pre-and-post meeting surveys to capture insights on the main challenges of results report generation (diagnostic companies) and accurate interpretation for patient care (oncologists) as well as recommended solutions and areas to jointly address. Recommendations were informed by an audit of 12 biomarker reports from commercial/ governmental labs for similarities and differences regarding report structure, terminology, and content. Results: Pre-meeting survey results and discussion from diagnostic companies (N = 12) and academic and community cancer center oncologists (N = 8) revealed multiple challenges with report generation as well as interpretation. Diagnostic companies highlighted the need for superior, time-intensive attention to detail for accurate evidence curation and report generation. Oncologists highlighted challenges reviewing and interpreting results such as inconsistencies in nomenclature for genomic variants, alignment of genomic alterations with approved therapies, and lack of clarification of the level of evidence for therapeutic selection. In post-meeting surveys, participants proposed solutions to harmonize specific aspects of biomarker testing reports to improve patient care. Top areas for alignment included establishing consensus on harmonization of clinical nomenclature, refining report structure, and shortening report length. Conclusions: It is not enough to only promote biomarker testing for lung cancer patients. Attention is also needed to systematically unify and streamline clinical biomarker reports to best serve the oncology community. These efforts may also serve as a model for application in other cancers beyond lung cancer.
Urethral augmentation using oral mucosa grafts after distal urethrectomy during radical vulvectomy
Authors: J. García Herrero, F. Campos Juanatey, E. Alonso Mediavilla, S. Zubillaga Guerrero, A.B. Muñoz Menendez, R. Mora Ruiz-Moyano, P. Calleja Hermosa, R. Varea Malo, E. Fernandez Guzman, N. Garcia Formoso, M. Sanchez Gil, G. Azcarraga Aranegui, A. Llamazares Alonso, I. Hernandez Alconchel, A. Azueta Etxebarria, M.Y. Jubete Castañeda, J.L. Gutierrez Baños
Journal: European Urology (2022)
The analysis of <i>CCND1</i> amplification in Chinese patients with esophageal carcinoma.
Authors: Lianke Liu, Fang ye Xu, Jiali Xu, Wei jie Sun, Yuange He, Qianwen Shao, Ting Wang
Journal: Journal of Clinical Oncology (2022)

e16073 Background: The CCND1 gene is considered an oncogene located on human chromosome 11q13.3, Cyclin D1 protein encoded by the CCND1 gene is the critical gatekeeping protein in charge of regulating the transition. Previous studies have reported that CCND1 amplification associated with a negative response to immune checkpoint inhibitors (ICIs) in pancancers, but the association with clinical and molecular characteristics in esophageal carcinoma (ESCA) have not been researched. Herein, we explore CCND1 amplification profiles in Chinese patients with ESCA. Methods: A total of 59 patients of ESCA with paired tumor-normal samples were collected into the study. All samples were detected by DNA based sequencing with a 1021 gene panel. Results: Firstly, the frequency of CCND1 amplification in Chinese ESCA patients was 32.20% (19/59). Then, all the samples were divided into two groups according to whether CCND1 was amplified or not. In the CCND1 amplification group, the top8 co-mutated genes were TP53, FGF4, FGF3, FGF19, MYC, NOTCH1, CDKN2A, CDKN2B. We calculated the clinical and molecular characteristics between the two groups, the results showed there were no difference in gender, age and TNM stage. Meanwhile, the CCND1 amplification group had more somatic mutations (median 19 vs. 11, P = 0.0003), higher TMB value (median 8.64 vs. 5.76, P = 0.0199) and more TMB-H patients (47.37% vs. 17.50%, P = 0.018). Indicating the CCND1 amplification is associated with TMB-H in ESCA. However, previous studies have reported the negative impact of CCND1 amplification on the efficacy of ICIs in pancancer (including ESCA), these results suggesting the efficacy of ICIs in ESCA may be affected by multiple biomarkers, especially for TMB-H patients should be concerned about the high frequency CCND1 amplification, the patients may have a poorer benefit from immunotherapy. Conclusions: The efficacy of ICIs in ESCA may be affected by multiple biomarkers, especially for TMB-H patients should be concerned about the higher frequency of CCND1 amplification, these patients may have a poorer benefit from immunotherapy.[Table: see text]
Candidate surrogate endpoints in advanced prostate cancer: Aggregate meta-analysis of 143 randomized trials.
Authors: Laila A Gharzai, Ralph Jiang, Elizabeth Jaworski, Krystal A Morales, Robert Timothy Dess, William C. Jackson, Holly Hartman, Rohit Mehra, Amar Upadhyaya Kishan, Abhishek A Solanki, Edward M. Schaeffer, Felix Y Feng, Nicholas George Zaorsky, Alejandro Berlin, Lee Evan Ponsky, Jonathan Evan Shoag, Yilun Sun, Matthew J. Schipper, Jorge A. Garcia, Daniel Eidelberg Spratt
Journal: Journal of Clinical Oncology (2022)

5039 Background: The Intermediate Clinical Endpoints (ICEs) in Cancer of the Prostate (ICECaP) working group identified metastasis-free survival as a valid surrogate endpoint for overall survival (OS) for patients with localized prostate cancer. No comparably validated surrogate endpoints for OS exist in advanced prostate cancer. Methods: In this meta-analysis, PubMed was searched for trials in advanced prostate cancer, defined as node positive (N1M0), metastatic castration-sensitive (mCSPC), non-metastatic (M0CRPC), or metastatic castration-resistant prostate cancer (mCRPC). Eligible randomized trials were required to report OS and ≥1 intermediate clinical endpoint (ICE). ICEs included biochemical-failure (BF), clinical failure (CF), BF-free survival (BFS), progression-free survival (PFS), radiographic PFS (radiographic +/- other study defined endpoints). Candidacy for surrogacy was assessed using the second condition of the meta-analytic approach, correlation of the treatment effect of the ICE and OS, using R 2 weighted by the inverse variance of the log ICE hazard ratio and defined as an R 2 &gt; 0.70. Results: A total of 143 randomized trials (n = 75,601 patients) were included. No candidate endpoints met criteria for surrogacy; R 2 BF (n = 28,922) 0.42 (95%CI 0.18-0.64), BFS (n = 25,741) 0.57 (95%CI 0.37-0.73), CF (n = 22,616) 0.31 (95%CI 0.0075-0.56), PFS (n = 52,639) 0.50 (95%CI 0.35-0.63), and radiographic PFS (n = 52,548) 0.50 (95%CI 0.35-0.63). Within preplanned subgroups by castration sensitive or resistant disease, or by treatment type, neither BFS nor PFS met criteria for surrogacy. When assessing radiographically-defined progression (exclusive or with clinical progression), PFS for the overall group and by castration status did not meet criteria for surrogacy. Sensitivity analyses demonstrated that candidacy for surrogacy of all endpoints tested did not change over time. Conclusions: Our aggregate screening method for surrogate endpoints in advanced prostate cancer demonstrated commonly used clinical endpoints are not valid surrogate endpoints for OS, and further composite endpoint construction is necessary.
A nomogram to predict pathological complete response of neoadjuvant systemic therapy in HER2-positive breast cancer based on clinicopathologic characteristics and pretreatment systemic inflammation response index: A dual-center study.
Authors: Hong-Yu Wu, Jie-Ru Yang, Chih-Chiang Hung, Chun-Hao Yin, Yen-Dun Tony Tzeng
Journal: Journal of Clinical Oncology (2022)

e12590 Background: Patients with human epidermal growth factor receptor 2 (HER2) positive breast cancer (BC) who achieve a pathologic complete response (pCR) after neoadjuvant systemic therapy (NST) have favorable prognoses. Multiple pretreatment systemic inflammatory markers (SIMs), based on peripheral blood cell counts, have been reported as predictors of pCR in BC patients. The markers include neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, lymphocyte-monocyte ratio, and systemic inflammation response index (SIRI= neutrophil × monocyte / lymphocyte count), etc. However, the most significant SIM remains controversial among studies and the variations among different molecular subtypes remain unknown. Methods: We retrospectively reviewed 233 patients with stage I–III HER2-positive BC who received NST and subsequently underwent surgery in Kaohsiung and Taichung Veterans General Hospital from 2011 to 2021. Data on multiple pretreatment SIMs were collected. The most significant SIM were analyzed for predictive significance with other clinicopathologic factors by using stepwise logistic regression with forward selection. The data was conducted to illustrate a nomogram plot for determining pCR probability. Results: Among the pretreatment SIMs, only SIRI was significantly related to pCR by optimal cut-off value of 1.7 ×10 9 /L. Stepwise logistic analyses indicated that the clinical T and N stage, HER2 immunohistochemistry (IHC) score, PR expression, and targeted therapy regimen were independent predictors of pCR, with an area under the curve (AUC) of 0.74. Sub-analysis was performed after stratifying into T stage subgroups (T1-2 vs. T3-4). Significant predictors In the T1-2 subgroup were clinical N stage, HER2 IHC score, PR, and targeted therapy regimen (AUC=0.722). Significant predictors in the T3-4 subgroup were SIRI and ER (AUC=0.824). The Hosmer–Lemeshow test revealed the predictive ability was a good fit to actual observation. A T-stage-stratified nomogram based on the logistic model was built. Conclusions: In HER2 positive BC patients receiving NST, low pretreatment SIRI is predictive of pCR in T3-4 subgroup. Our nomogram served as an efficient tool to predict pCR and to assist clinical decision support before neoadjuvant treatment.
Combination Antidepressant Therapy vs Monotherapy—Further Considerations
Authors: Qi Wang, Liang Yao, Yaolong Chen
Journal: JAMA Psychiatry (2022)

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